Galwegians must take opportunity to help shape nursing home standards

by mary O’Connor Galway Advertiser, Thu, Aug 21, 2014

“Horrific” cases involving the abuse of elderly and vulnerable residents in some Irish nursing homes over the years have hammered home to families the importance of speaking out if concerns arise, according to the former chairperson of the HSE’s regional health forum, Galway Cllr Padraig Conneely.

Speaking in the wake of the health watchdog HIQA launching a public consultation process to seek feedback on draft national standards for nursing homes, he is urging families and residents to tell the organisation about their priorities and how they believe care standards can be improved.

By speaking out people will have an opportunity to shape how care services are provided in Ireland and protect one of the most vulnerable groups in the community, the former Fine Gael Galway city mayor outlined.

Issues, such as medical errors, physical and verbal abuse, lack of supervision and poor care standards in some nursing homes, which hit the headlines, eroded public confidence in the sector, he believed. However now the public can “have their say” and influence the new standards,

The latest statistics indicate there are about 1,800 people using residential care services throughout Galway. There are 43 nursing homes here.

Cllr Conneely says strict selection guidelines, screening and constant monitoring of staff must be a priority in the new nursing home standards, while families must be watchful too and act on any concerns they have.

The city councillor says our ageing population means an increasing proportion of people will need nursing home care in the future. It is paramount top standards are set and adhered to and providing feedback to HIQA will help develop such guidelines. “Feedback is important because it will form the policies of the future,” he adds.

Mary Tierney, a local advocate with Patient Focus, says it is important to remember that nursing homes are not “institutions but homes from homes” for people. “The quality of life of the whole person - their physical, mental and emotional needs - must be borne in mind.

Providing a bed is not sufficient, multi-disciplinary care must be available, their dietary, physiotherapy, and emotional needs must be met, for example. Some may want a visit of a chaplain, some may not. We know many people go to nursing homes and are left there, as if they are never going to get out of there again. But with proper stimulation and encouragement they could get back to their normal lives. They must not be left there, like a forgotten species. Just because one is old or unable to communicate does not mean that they should be treated any differently to someone who can defend their rights.

“Patient Focus has had to provide mediation for families to discuss the medical and holistic needs of residents in some nursing homes, not necessarily in Galway. There should always be avenues of communication for families to access management. If a relative rings to find out how a loved one is or expresses a concern they should be dealt with in a professional manner, it should not be seen as a complaint.”

Ms Tierney highlights the importance of an incident report system whereby matters are taken seriously when reported by staff or concerned family.

“Some patients can’t tell what is happening to them, through illness they have no speech. Sometimes, in old age too, people become ‘awkward’ but that does not mean they should not be believed. There was a case (not in Galway ) where a man went to visit his mother in a nursing home, who was not old but had suffered a stroke. She had been complaining [of pain] for a week. She was taken to hospital and was told she had a broken shoulder. When her son asked about it, he was told by the nursing home that she had fallen. But his mother said she was dropped. There are guidelines for people handling patients for both the safety of the patient and carer, but in this case only one person lifted her. The health care provider denied it. The mother had broken her shoulder but her son was afraid to speak out in case of a negative impact.”

The new national standards will apply to all nursing homes and other care settings such as geriatric hospital wards run by the HSE, private organisations or voluntary bodies. Registered nursing homes are then inspected by HIQA on a regular basis to ensure they meet the standards.

HIQA first published National Quality Standards for Residential Care Settings in 2009. These draft standards are a revision, which take into account feedback from providers and residents living in residential care settings as well as evidence-based international research over the past five years.

The final date for receipt of public feedback is September 24. To take part in the consultation log on to www.hiqa.ie which contains copies of the draft standard. These documents are also available from all nursing homes.